Our experience with intraoperative cell salvage during cesarean delivery in women with uterine myomas: Four case reports

Introduction. Cesarean section is more frequent in pregnant women with uterine myomas, and is usually complicated with perioperative hemorrhage. In some cases, cesarean myomectomy represents an inevitable surgery, adding risk of hemorrhage occurrence. Massive obstetric hemorrhage is the most common cause of maternal mortality and morbidity. The aim of this study was to show our experience and results of the implementation of intraoperative blood salvage during cesarean section in the patients with uterine myomas. Material and Methods. The study encompassed four patients with uterine myomas who had cesarean delivery at our Department in the period from 2010 to 2011. Results. Postoperative transfusion of packed red blood cells was given to one patient. No complications resulting form the intraoperative blood salvage were recorded in our research. Conclusion. Intraoperative blood salvage should be applied in patients with uterine myoma, and certainly in those who are planned for cesarean myomectomy and particularly in cases when massive intraoperative hemorrhage is expected.

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Intraoperative Blood Salvage During Cesarean Delivery in a Patient with β Thalassemia Intermedia

Anesthesia & Analgesia ◽

10.1213/01.ane.0000087046.91072.e8 ◽

2003 ◽

Vol 97 (6) ◽

pp. 1808-1809 ◽

Cited By ~ 18

Author(s):

Jonathan H. Waters ◽

Egle Lukauskiene ◽

Michael E. Anderson

Keyword(s):

Cesarean Delivery ◽

Thalassemia Intermedia ◽

Blood Salvage ◽

Intraoperative Blood Salvage

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Comparison of maternal mortality and morbidity between trial of labor and elective cesarean section among women with previous cesarean delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.03.022 ◽

2004 ◽

Vol 191 (4) ◽

pp. 1263-1269 ◽

Cited By ~ 76

Author(s):

Shi Wu Wen ◽

◽

I.D. Rusen ◽

Mark Walker ◽

Robert Liston ◽

...

Keyword(s):

Cesarean Section ◽

Maternal Mortality ◽

Cesarean Delivery ◽

Elective Cesarean Section ◽

Mortality And Morbidity ◽

Trial Of Labor ◽

Maternal Mortality And Morbidity ◽

Elective Cesarean ◽

Previous Cesarean

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Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0305 ◽

2021 ◽

Vol 49 (1) ◽

pp. 5-16

Author(s):

Clarel Antoine ◽

Bruce K. Young

Keyword(s):

United States ◽

Black Women ◽

Cesarean Section ◽

Cesarean Delivery ◽

Surgical Techniques ◽

The United States ◽

Delivery Rate ◽

Mortality And Morbidity ◽

Perceived Safety ◽

Cesarean Delivery Rate

AbstractIn present-day obstetrics, cesarean delivery occurs in one in three women in the United States, and in up to four of five women in some regions of the world. The history of cesarean section extends well over four centuries. Up until the end of the nineteenth century, the operation was avoided because of its high mortality rate. In 1926, the Munro Kerr low transverse uterine incision was introduced and became the standard method for the next 50 years. Since the 1970’s, newer surgical techniques gradually became the most commonly used method today because of intraoperative and postpartum benefits. Concurrently, despite attempts to encourage vaginal birth after previous cesareans, the cesarean delivery rate increased steadily from 5 to 30–32% over the last 10 years, with a parallel increase in costs as well as short- and long-term maternal, neonatal and childhood complications. Attempts to reduce the rate of cesarean deliveries have been largely unsuccessful because of the perceived safety of the operation, short-term postpartum benefits, the legal climate and maternal request in the absence of indications. In the United States, as the cesarean delivery rate has increased, maternal mortality and morbidity have also risen steadily over the last three decades, disproportionately impacting black women as compared to other races. Extensive data on the prenatal diagnosis and management of cesarean-related abnormal placentation have improved outcomes of affected women. Fewer data are available however for the improvement of outcomes of cesarean-related gynecological conditions. In this review, the authors address the challenges and opportunities to research, educate and change health effects associated with cesarean delivery for all women.

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Complications during cesarean delivery in a patient with two previous myomectomies

Acta chirurgica iugoslavica ◽

10.2298/aci1301099s ◽

2013 ◽

Vol 60 (1) ◽

pp. 99-100 ◽

Cited By ~ 4

Author(s):

Radmila Sparic ◽

Milica Berisavac ◽

Snezana Buzadzic ◽

Ljiljana Mirkovic

Keyword(s):

Cesarean Section ◽

Cesarean Delivery ◽

Postoperative Recovery ◽

High Rate ◽

Uterine Myomas ◽

Cesarean Deliveries ◽

Fetal Complications

Introduction: Myomas are associted with numerous pregnancy-related maternal and fetal complications, including high rate of cesarean deliveries. Case Outline: We present a woman with huge posterior myoma who had two previous myomectomies. During the cesarean section, the anatomy was found to be grossly distorted. Thus it was necessary to make an inverted T-incision on the uterus, which facilitated delivery of the fetus. The patients postoperative recovery was uneventful. Conclusion: This case illustrates the difficulties that may arise during cesarean section in the presence of uterine myomas in women with previous myomectomies. Clinicians should be prepared to manage those difficulties with inverted T-incision in order to prevent fetal injuries. Such operations should be performed by an experienced obstetrician.

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Cesaraean myomectomy: A lesson learnt

Indian Journal of Obstetrics and Gynecology Research ◽

10.18231/j.ijogr.2021.085 ◽

2021 ◽

Vol 8 (3) ◽

pp. 413-415

Author(s):

Monika Anant

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Cesarean Section ◽

Hemorrhagic Shock ◽

Surgical Procedure ◽

Case Reports ◽

Case Selection ◽

Life Threatening ◽

Cesarean Myomectomy

Cesarean myomectomy (CM) has been a controversial surgical procedure. It is fraught with increased blood loss and its associated postoperative morbidities of anemia, blood transfusion and sepsis or even an unintended obstetric hysterectomy. This case reports a life-threatening hemorrhagic shock in a patient for whom 2 large myomas were extracted during cesarean section. Safety of CM depends on proper case selection with small sized, subserous, pedunculated fibroids and the speed and skill of surgeon.

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Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-021-00154-6 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Nevein Gerges Fahmy ◽

Fahmy Saad Latif Eskandar ◽

Walid Albasuony Mohammed Ahmed Khalil ◽

Mohammed Ibrahim Ibrahim Sobhy ◽

Amin Mohammed Al Ansary Amin

Keyword(s):

Blood Loss ◽

Cesarean Section ◽

Tranexamic Acid ◽

Postpartum Hemorrhage ◽

Postoperative Bleeding ◽

Control Group ◽

Study Group ◽

Mortality And Morbidity ◽

Lower Segment Cesarean Section ◽

Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

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Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

JA Clinical Reports ◽

10.1186/s40981-021-00430-2 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Junnosuke Kimura ◽

Kento Kawamura ◽

Manami Minoura ◽

Ayako Hiramoto ◽

Yoshifumi Suga ◽

...

Keyword(s):

Case Report ◽

High Risk ◽

Cesarean Section ◽

General Anesthesia ◽

Pregnant Women ◽

Cesarean Delivery ◽

Business Communication ◽

Communication Tools ◽

Case Presentation ◽

Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

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